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HYALOMATRIX

Nebraska rates for HCPCS Q4117

HYALOMATRIX, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated October 2026.

How much does HYALOMATRIX cost?

$28.84

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $28.84 for this service. The price depends on where it is billed: about $28.84 from a physician practice, and about $19.05 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$28.84$22.91 to $120
FacilityA hospital or hospital-owned outpatient department$19.05$18.20 to $107

How much rates vary

Facilitymedian $19 · 10th to 90th $16 to $224Professionalmedian $29 · 10th to 90th $19 to $126
$20$50$100$200facility $19professional $29

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$28.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$22.91
BCBS Nebraska
Setting
Facility
Modifier
None
Typical Low
$15.85
Median
$18.62
Typical High
$19.05
BCBS Nebraska
Setting
Professional
Modifier
None
Typical Low
$18.20
Median
$19.05
Typical High
$19.05
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$223.87
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$19.50
Median
$28.84
Typical High
$158.49
Medica
Setting
Facility
Modifier
None
Typical Low
$16.98
Median
$43.65
Typical High
$107.15
Medica
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$28.84
Typical High
$31.62
Midlands
Setting
Professional
Modifier
None
Typical Low
$19.50
Median
$28.84
Typical High
$316.23
Midlands
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$223.87
Typical High
$331.13
Midlands
Setting
Professional
Modifier
None
Typical Low
$19.50
Median
$19.50
Typical High
$158.49
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$125.89

Where Nebraska sits

The same service costs 8.3 times more in North Dakota than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Nebraska· 30th of 51

$28.84

ND $141KY $16.98

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.